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Your guide to cardiac surgery

Heart surgery

During cardiac surgery, patients can suffer serious complications that can leave them in a worse position than they expected. If this is due to a poor standard of surgery, sub-standard after-care or insufficient investigations before the procedure, they may have a claim for medical negligence and be entitled to compensation.

Common problems in cardiac surgery can involve:

  • Excessive bleeding
  • Blood clotting
  • Injury to heart valves or blood vessels
  • Infection

Before surgery takes place, a doctor, surgeon or specialist should clearly explain to you any concerns they may have regarding the procedure itself and the possible outcomes.

The risk of a complication during or after heart surgery is likely to be higher if you have another condition, such as diabetes, kidney disease, lung disease, or peripheral arterial disease (narrowing of the arteries in the legs).

If you or a member of your family has suffered a loss, an injury or permanent physical disability caused by an error made during cardiac surgery, your first step is to seek professional advice.

The hospital’s ‘Duty of Candour’

All hospital trusts have a legal duty to both inform and apologise to patients if mistakes have been made while in their care, which led to preventable harm, injury or loss.

Finding out why errors occurred and proving clinical negligence was the cause require knowledge of both legal and medical issues, and a sensitive understanding of how everyone involved is affected.

Our dedicated team of specialist solicitors has many years of experience in successfully resolving different types of clinical negligence cases. We can help you find out why things went wrong and, crucially, obtain compensation to ensure the financial needs of providing the necessary care, treatment and support are properly met.

Cardiac surgery statistics (latest available)

  • 2.7% of patients in the UK do not survive cardiac surgery.          (NHS England, 2013)
  • 98.7% of patients in the UK survive a coronary artery bypass procedure.          (Central Cardiac Audit Database, 2012-13)
  • 34, 174 cardiac operations were performed in the UK in 2012, of which 3% of patients failed to survive.
  • 67 years is the average age for receiving cardiac surgery.
  • A patient’s age represented a 67.1% risk factor in surviving cardiac surgery (2012).
  • 57 – 64% of patients on average in the UK survive 12.3 years following cardiac surgery.          (The Society for Cardiothoracic Surgery in Great Britain & Ireland) 

What is cardiac surgery?

Cardiac surgery refers to the procedures that are performed by a specialist cardiac surgeon on the heart itself and/or the surrounding blood vessels.

What are the most common types of cardiac surgery?

  • Open-Heart Surgery

Open-heart surgery, which refers to the opening of the chest not the heart, is used for:

- Coronary artery bypass operations.

- Repairing or replacing heart valves.

- Treating atrial fibrillation - an irregular and often abnormally fast heart rate.

- Heart transplants.

A surgeon makes a large incision (cut) in the chest to open the rib cage and operate on the heart.  The surgeon also may open the heart, depending on the type of surgery. The patient is connected to a heart-lung bypass machine, which takes over the heart's pumping action and moves blood away from the heart. The surgeon is then able to operate on a heart that is neither beating nor has blood flowing through the chambers.

  • Coronary Artery Bypass Grafting  (CABG)

A blood vessel is removed from another part of the body – usually the chest, leg or arm – and attached above and below the narrowed or blocked area of the coronary artery. The new blood vessel, known as a graft, ‘bypasses’ the narrowed or blocked parts of the artery to improve blood flow and oxygen supply to the heart.

A CABG is carried out under general anaesthetic and usually takes between three and six hours to complete.

Around 20,000 CABG procedures are performed in England every year, most of which are carried out on males, 80% of whom are aged 60 years and above.

  • Aortic  Valve Repair or Replacement

The aortic valve is a flap that acts as a one-way gate, opening and closing to control the flow of blood out of the left hand side ventricle (chamber) of the heart to the main artery, known as the aorta.

The aortic valve may need to be replaced if:

- the valve becomes narrowed and obstructs the blood flowing through.

- the valve leaks and blood flows back into the left ventricle.

- the valve no longer works properly.

The heart is stopped and the aortic valve is removed and replaced with an artificial valve, known as a prosthesis.

Around one in 50 patients will not survive the procedure, due to  complications that arise either during or shortly after surgery.

  • Aneurysm Repair

An aneurysm in the heart most often occurs in the heart's lower left ventricle (chamber).

An aneurysm is a balloon-like bulge in the wall of an artery or heart muscle, which can occur if the artery wall becomes weak. Pressure from blood passing through the artery or heart causes the weakened area to bulge.  Over time, an aneurysm can grow and burst, causing dangerous, often fatal, internal bleeding.

Surgery to repair an aneurysm involves replacing the weak section of the artery or heart wall with a patch or graft.

  • Pacemaker Implant

 A pacemaker is a small electrical device implanted in the chest, which is attached by a wire to the heart and sends electrical pulses to help keep the heart beating regularly.

An implantable cardioverter defibrillator (ICD) is similar to a pacemaker, but sends a larger electrical shock to get the heart pumping again.

The pacemaker is implanted under the skin near the collarbone on the left side of the chest and attached to a wire via a blood vessel to the heart.

The procedure is carried out under local anaesthetic and usually takes around one hour.

Common complications of cardiac surgery

Heart surgery complications can be different for each patient but the most common complications are:

  • Excessive bleeding.
  • Blood clotting.
  • Neurological disorders - caused by blood clotting and lack of oxygen supply, which can lead to memory loss, paralysis, epilepsy, and cerebral palsy.
  • Stroke.
  • Irregular heartbeats.
  • Injury to heart valves or blood vessels.
  • Heart valve or tissue damage.
  • Severing of the aortic valve.    
  • Blood fills the sac surrounding the heart.
  • Infection. 

Negligence in cardiac care

Misdiagnosis and mistakes may also occur, which can delay cardiac surgery.

A GP or doctor may mistakenly diagnose a patient's symptoms as benign (harmless) or a minor health issue. A failure or delay in arranging a referral to a specialist for further tests could be life-threatening.

In rare cases, injuries can arise during or after cardiac surgery with potentially serious consequences. A specialist may delay carrying out the appropriate investigations or incorrectly interpret test results. 

Cardiac surgery negligence – do I have a claim?

To bring a successful negligence claim, it will be necessary to prove that:

  • The treatment received fell below a generally accepted standard expected from a cardiac surgeon
  • The injury or harm suffered must have been avoidable ‘at the time and in the circumstances’.

How Your Legal Friend can help you

As experienced clinical negligence specialists, we understand that you will want to find out why your surgeon failed you or a family member in their duty of care.  We ensure your case is properly investigated and your voice heard in order to bring the hospital, health trust or medical practitioner to account for the harm and suffering they have caused, and to prevent others from suffering in a similar way.

From the first time we discuss the special circumstances of your case, Your Legal Friend is committed to ensuring victims of clinical negligence obtain answers and receive the maximum compensation so that their future medical treatment and care needs are properly met.